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| ID | Type | Description | Link |
|---|---|---|---|
| P30AG024968 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute on Aging (NIA) | NIH |
| Contra Costa Health | UNKNOWN |
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This study is a Stage III randomized trial to encourage patients in advance of a health care appointment to designate a healthcare proxy. Patients will be randomly assigned to receive a mailer containing information about designating a healthcare proxy, or to not receive any mailer. For patients assigned to receive a mailer, the mailer will differ by the presence or absence of a patient pre-commitment prompt, and contain a personalized provider request or a generic health system request. The work will evaluate the randomized trial and identify factors that predict intervention effectiveness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Provider Mailer with a Pre-commitment Prompt | Experimental | Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by their primary care provider. |
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| Health System Mailer with a Pre-commitment Prompt | Experimental | Patients will receive a mailer containing a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system |
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| Provider Mailer without a Pre-commitment Prompt | Experimental | Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the patient's provider. |
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| Health System Mailer without a Pre-commitment Prompt | Experimental | Patients will receive a mailer, but it will not contain a pre-commitment prompt to bring in a form listing their healthcare proxy to their next primary care visit. The mailer will be sent from and signed by the health system. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mailer | Behavioral | Patient mailers will ask the patient to name a healthcare proxy at their next primary care visit. |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with EHR-documented healthcare proxy | Documentation in the electronic health record of a healthcare proxy | Within 30 days of the patient's first scheduled primary care visit |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with legal advance care planning documentation | Documentation in the electronic health record of any legal advance care planning document, including an advance directive or power of attorney | Within 30 days of the patient's first scheduled primary care visit |
| Proportion of patients that attended scheduled visit |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mireille Jacobson, PhD | University of Southern California | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Contra Costa Regional Medical Center | Martinez | California | 94553 | United States |
De-identified IPD used for results publication may be shared upon request and with approval by the health system.
IPD will be available for one year after the study publication date.
IPD access criteria will be governed by a data use agreement signed by both parties.
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2 x 2 factorial + a no intervention control group
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Hospital staff, including clinicians, will not be alerted to the patient's assigned intervention. However, clinicians may learn of the patient's assigned intervention if the patient brings their mailer to the visit.
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| No Mailer Control | No Intervention | Patients will not receive a mailer. |
| Provider Request | Behavioral | Patient mailers will be sent from and signed by the patient's provider for their next scheduled primary care visit. |
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| Pre-commitment Prompt | Behavioral | Patient mailers will contain a box that asks the patient to bring a form with their choice for a healthcare proxy to their next primary care visit. |
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Patient attended the scheduled primary care visit |
| On the date of the patient's first scheduled primary care visit |
| Proportion of patients with EHR-documented healthcare proxy within 90 days | Documentation in the electronic health record of a healthcare proxy | Within 90 days of the patient's first scheduled primary care visit |
| Proportion of patients with legal advance care planning documentation within 90 days | Documentation in the electronic health record of any legal advance care planning document, including an advance directive or power of attorney | Within 90 days of the patient's first scheduled primary care visit |
| Proportion of patients with primary care visit within 90 days | Patient attended a primary care visit | Within 90 days of the patient's first scheduled primary care visit |